VASCULAR ENDOTHELIAL GROWTH-FACTOR EXPRESSION IN HEAD AND NECK SQUAMOUS-CELL CARCINOMA

BACKGROUND: Angiogenesis is an essential process required for growth a nd metastasis in cancer. In breast, gastric, and prostate cancer, vasc ular endothelial growth factor (VEGF) has been implicated in angiogene sis; however, little is known about VEGF in HNSCC. In this study, we h ypothesize thai VEGF is present in elevated levels in HNSCC and may th erefore play a role in promoting angiogenesis. METHODS: We obtained tu mor tissue from 63 HNSCC patients undergoing primary resection. All ti ssue samples were analyzed by immunohistochemistry (IHC) techniques fo r the presence and localization of VEGF; however, only 36 had sufficie nt amounts of tissue for quantitative analysis of VEGF by ELISA. Nine control specimens taken from patients undergoing uvulopalatopharyngopl asty were also analyzed. RESULTS: In all 63 of our patient samples we found VEGF to be present and localized to the cancer cells and endothe lial cells, The poorly differentiated cancer cells stained more intens ely in comparison with the well-differentiated ones, There was a 20-fo ld increase in the patient levels when compared with controls levels ( P greater than or equal to 0.05). Analysis by enzyme-linked immunosorb ent assay revealed elevated mean levels of VEGF (241 +/- 326 pg/mg tot al protein [TP]) with a range of 2 to 1484 pg/mg TP. The control speci mens had mean levels of 13 +/- 11 pg/mg TP and a range of 1 to 78 pg/m g TP. Patients who exhibited higher levels of VEGF tended to have a hi gher rate of disease recurrence (P less than or equal to 0.048) and sh orter disease-free interval (P less than or equal to 0.05). CONCLUSION S: The expression of VEGF in elevated levers in the HNSCC tumor microe nvironment appears to be associated with more aggressive disease. Base d on our results, VEGF may be an important angiogenic factor associate d with cancer cells and endothelial cells in HNSCC. Further studies ar e needed to better define the role of VEGF in HNSCC and its role as a potential target for therapeutic intervention. (C) 1997 by Excerpta Me dica, Inc.